NIV receives blood samples from Bihar

Jun 23, 2011, 06.12am IST
PUNE: The Pune-based National Institute of Virology (NIV) received four samples of blood, urine and fluid surrounding the brain and spine of children infected with a viral infection from Bihar on Wednesday. Twenty-six children have died of a mysterious illness in Muzaffarpur, Sheohar and adjoining districts of Bihar in the last few days. The children were all in the age group of two-and-a-half to six years.

"Prima facie, these are cases that fall under Acute Encephalitis Syndrome (AES), characterised by inflammation of the brain. Fatalities in AES are very high. Globally, the cause in 40 to 50 per cent of encephalitis cases is never ascertained. The Chandipura virus, which occurred in Nagpur, also caused similar illness and fatality," A C Mishra, director of NIV told TOI.

"Around five years ago, a similar outbreak was reported from Bihar. We had collected samples during that time but the disease-causing agent could not be detected," said Mishra. "This happens not only in India but across the world. In 40 % to 50 % of encephalitis cases, the agent is not known. This is because the technology for detecting the disease-causing agent is still not advanced enough.

"We have twice used frontline diagnostic methods in testing the samples we received, but we could not detect the agent. Efforts are on but we need some time. We hope to find out the cause this time," Mishra said.

Tuesday the NIV had ruled out Japanese encephalitis (JE) as the cause of the children's deaths.


The mysterious illness is largely seen in children living near the lychee gardens in the affected districts of Bihar. The lychee fruit ripens when the summer is ending and the monsoon is about set in. We are looking to see if there is any connection. Our seven-member team that has gone to the affected districts are also taking samples of animals and insects from the adjoining areas of the affected districts in Bihar," Mishra said.

AES, including JE, is reported mainly from Assam, Bihar, Karnataka, Tamil Nadu and Uttar Pradesh, which have approximately 80% of cases and deaths with a case fatality rate of 20 to 25 %. Specific antiviral drugs for AES are not available and the cases are managed symptomatically, states the official website of the national vector-borne disease control programme (NVDCP) of the Government of India.

Clinically, a case of AES is defined as a person of any age, at any time of year, with the acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk.

Other early clinical findings may include an increase in irritability, somnolence or abnormal behaviour greater than that seen with usual febrile illness.